Clindamycin Cream
What is it?
Clindamycin is an antibiotic which can be taken by mouth or applied to the surface of the skin. We use it only on the skin. It inhibits the growth of cutibacterium acnes in your oil glands. It is mixed with a cream or liquid and applied to all areas that are prone to developing acne. A 1% mixture often helps acne in the beginning, but stops working when bacteria become resistant. This can happen even when it's mixed with benzoyl peroxide. At higher concentrations, clindamycin 3-4% may have an anti-inflammatory effect, so that it will help your acne even if bacteria are resistant. It's effect is likely similar to minocycline 4% foam (Amzeeq) which is available in the USA, but not yet in Canada.
How do I use it?
Wash your face with a just water or a gentle cleanser. Apply a thin layer of the cream all over the face, except around the eyes and on the lips. Leave the medication on the face until the next time you wash your face. Apply the medicine twice a day, so that it's always on the skin.
When will it start to work?
Clindamycin will not take away the pimples that are already there. Nor will it instantly stop new pimples from coming. It will gradually reduce the number of new pimples, blackheads, and whiteheads that form on your skin. You should see a decrease of about 50% in the number of pimples in the first month, and 70-80% by the end of the second month. Once you are better, you must keep on using it, or the pimples will come back.
What side effects does it have?
The most common side effect is skin irritation. If your skin starts to burn or becomes itchy, red, irritated or flaky, use it less often or stop altogether. In higher concentrations, it sometimes smells, but this goes away as the medication dries. Very, very rarely, clindamycin cream can cause a severe form of diarrhea called pseudomembranous colitis. For this reason, people with inflammatory bowel disease, Crohn's or ulcerative colitis should not use this medication. If you develop diarrhea, bloody stools or stomach cramps, call your doctor.
Is it safe if I'm pregnant or breast feeding?
Clindamycin has no known ill effects on the fetus. However, there is some absorption of the medication through the skin, and a small amount excreted in the breast milk, so its use in pregnancy and during breast feeding should be discussed with your doctor.
Is this the only medicine I need?
Some people do well with only this medication, although most use it along with benzoyl peroxide gel to prevent development of bacterial resistance. This will help ensure the medication keeps working. Some people also use a Vitamin A Acid, Stieva A or Retin A cream with it to get the best result. These may be added later in your treatment.
When can I stop using it?
Clindamycin will keep your acne under control while you're using it. If you stop using it too soon, acne will come back. If you want to keep your acne under control, you need to keep on using the medication until you outgrow this condition. Fortunately, there is usually no problem with using clindamycin on the skin for a long time. Some people end up using it for several years.
How much does it cost?
This cream is not available commercially and has to be made for you specially by the pharmacist. Cost can vary quite a bit, from $15-$100 for 2 months worth of medication, so you may want to shop around. In our area, Costco usually charges $15, Walmart $20, and our local pharmacist $25.